scholarly journals School-based HPV Vaccination: The Challenges in a Brazilian Initiative

Author(s):  
Julio Cesar Teixeira ◽  
Mariana Silva Castro Vianna ◽  
Diama Bhadra Vale ◽  
Daniella Moretti Arbore ◽  
Thais Helena Wilmers Perini ◽  
...  

Abstract Objective The present study assesses the implementation and the impact after 2 years of a school-based human papillomavirus (HPV) vaccination program in a Brazilian city. Methods A prospective study assessing the implementation of the program, offering quadrivalent HPV vaccine in two annual doses to girls and boys aged from 9 to 10 years old. The program was started in the city of Indaiatuba, state of São Paulo, Brazil, in 2018, and had authorization from the National Immunization Program. The number of HPV vaccine first doses applied and the coverage in 2018 was calculated and compared to the year 2017. There were described events that have influenced the results. Results The program invited 4,878 children through schools (87.1% of the target population), and 7.5% refused vaccination. Several concurrent events required or competed for health professionals of the vaccination teams. The coverage of the first dose (between 9 and 10 years old) was 16.1% in 2017 and increased to 50.5% in 2018 (p < 0.0001). The first dose in all ages increased 78% in 2018 compared with 2017 (6,636/3,733). Competing demands over the program continued in 2019, and the first dose coverage dropped (26.9%). For 2020, a municipal law instituted school-based vaccination and the creation of dedicated teams for vaccination, and these strategies are waiting to be tested. Conclusion School-based annual HPV vaccination in children between 9 and 10 years old was feasible and increased vaccination coverage, regardless of gender, although the program was vulnerable to competing events.

2017 ◽  
Vol 44 (4) ◽  
pp. 548-558 ◽  
Author(s):  
Dudith Pierre-Victor ◽  
Mary Jo Trepka ◽  
Timothy F. Page ◽  
Tan Li ◽  
Dionne P. Stephens ◽  
...  

The Advisory Committee on Immunization Practices recommends routine human papillomavirus (HPV) immunization for 11- to 12-year-old adolescents. In 2008, Louisiana required the school boards to distribute HPV vaccine information to parents or guardian of students in Grades 6 to 12. This article investigates the impact of this policy on HPV vaccination among 13- to 17-year-old female adolescents using National Immunization Survey-Teen (NIS-Teen) data. Drawing on the data from the 2008 to 2012 NIS-Teen, we compared the difference in proportions of females who have been vaccinated before and after the policy. Using difference-indifference estimation, we explored the change in vaccination rates before and after the policy implementation in Louisiana compared with Alabama and Mississippi, two states that did not have such a policy in place. The difference-in-differences estimates for HPV vaccination were not significant. Physician recommendation for HPV vaccination was significantly associated with vaccination among females in Louisiana and Alabama (adjusted odds ratio [aOR] = 7.74; 95% confidence interval [CI; 5.22, 11.5]), and for those in Louisiana and Mississippi (aOR = 7.05; 95% CI [4.6, 10.5]). Compared to the proportion of female adolescents who had received physician recommendation in Alabama or Mississippi, the proportion in Louisiana did not increase significantly in the postpolicy period. HPV vaccination rates did not increase significantly in Louisiana compared to Alabama or Mississippi following the implementation of the policy. Despite Louisiana’s policy, physician recommendation remains the key determinant of HPV vaccination. HPV vaccine awareness does not necessarily result in HPV vaccination.


2009 ◽  
Vol 14 (46) ◽  
Author(s):  
C Simoens ◽  
M Sabbe ◽  
P Van Damme ◽  
P Beutels ◽  
M Arbyn

This paper documents the progress of human papillomavirus (HPV) vaccine introduction in Belgium. Information on vaccine use is based on sales statistics and reimbursement claims. From November 2007 to November 2008, the National Institute for Health and Disability Insurance reimbursed the HPV vaccine for girls aged between 12-15 years. In December 2008, the age limit was extended to include girls up to the age of 18. In November 2008, the total number of HPV vaccines sold exceeded 530,000 doses. The number of vaccines reimbursed in Belgium, for the period November 2007-November 2008, corresponds to the amount required to fully vaccinate 44% of all girls aged between 12-15 years. However, the trend was decreasing over the last 10 months. By the current reimbursement policy, we can expect that maximum half of the target population can be reached. In Flanders (one of the three Communities in Belgium), the intention is to start, from September 2010, with a free school-based HPV immunisation for girls in the first year of secondary school (12 years of age), complemented with vaccination by a physician of choice. This strategy ensures a higher HPV vaccine coverage which is expected to be as high as the current coverage in the hepatitis B vaccination programme (approximately 80%) offered to boys and girls in the same age group and under the same circumstances.


2013 ◽  
Vol 02 (04) ◽  
pp. 187-192 ◽  
Author(s):  
Partha Basu ◽  
Dipanwita Banerjee ◽  
Priyanka Singh ◽  
Chandrani Bhattacharya ◽  
Jaydip Biswas

AbstractThe Human Papillomavirus (HPV) vaccines have been widely introduced in the national immunization programs in most of the medium and high income countries following endorsement from national and international advisory bodies. HPV vaccine is unique and its introduction is challenging in many ways – it is the first vaccine developed to prevent any cancer, the vaccine is gender specific, it targets adolescent females who are difficult to reach by any health intervention programs. It is not unusual for such a vaccine to face scepticism and reservations not only from lay public but also from professionals in spite of the clinical trial results convincingly and consistently proving their efficacy and safety. Over the last few years millions of doses of the HPV vaccine have been administered round the world and the efficacy and safety data have started coming from the real life programs. A comprehensive cervical cancer control program involving HPV vaccination of the adolescent girls and screening of the adult women has been proved to be the most cost‑effective approach to reduce the burden of cervical cancer. The present article discusses the justification of HPV vaccination in the backdrop of natural history of cervical cancer, the mechanism of action of the vaccines, efficacy and safety data from phase III randomized controlled trials as well as from the national immunization programs of various countries.


Vaccines ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 176 ◽  
Author(s):  
Jarim Kim

Human papillomavirus (HPV) vaccine hesitancy contributes to unsatisfactory vaccination coverage in Korea despite its high efficacy in preventing various diseases including cervical cancer. To enhance HPV vaccine uptake, effective communication with the public is key. To develop effective health promotion messages, this study examined the effects of message format on attitudes and intentions toward HPV vaccination, specifically focusing on anticipated action and inaction regrets. It employed a randomized experimental message design format (narrative versus didactic messages). A total of 222 Korean undergraduate students who had not received the HPV shot participated in the experiment. The results showed that didactic messages produce greater anticipated inaction regret, which further influences HPV vaccination attitudes and behaviors. Anticipated regret could potentially explain mixed narrative effects across health behaviors as described in existing literature.


2020 ◽  
Author(s):  
Young Argyris ◽  
Yongsuk Kim ◽  
Won Song

BACKGROUND The propagation of vaccine misinformation during the COVID-19 pandemic suggests that the pandemic may pose long-term harm on public health via depressed immunization rates. Between February 2020 and April 2020, the uptake rates of the HPV vaccine have decreased by 73%. Missing the critical age for HPV vaccination (i.e., 11-12 years old) will make adolescents susceptible to HPV-associated cancers in the next 20-30 years. Despite the importance, very few pro-vaccine interventions conducted on SM have succeeded in increasing HPV vaccination rates. OBJECTIVE Our overall objective is to identify the reasons why anti-vaccine messages effectively lower HPV vaccination rates while pro-vaccine messages do not increase such rates. In so doing, we suggest that overarching vaccine hesitancy is a reason for the discrepant outcomes of anti- vs. pro-vaccine SM posts. Our objective is pursued in two specific aims: we compare anti- and pro-vaccine posts in terms of (i) their roles in fostering overarching vaccine hesitancy among mothers (the main HPV vaccine decision-makers), and (ii) accompanying HPV vaccination rates among their adolescent children. METHODS In late December of 2019-mid January of 2020, we conducted a population-based survey among 426 mothers of US adolescents aged 13–18. The outbreak of the novel coronavirus in China occurred in December 2019, and awareness regarding the virus was increasing in the US during this time. Therefore, our data collected during this time allow us to infer the impact of increasing overarching vaccine hesitancy on HPV vaccination rates, while excluding the effects of access restrictions to healthcare facilities imposed since March of 2020. We developed a rigorous scale for engagement with anti- and pro-vaccine SM posts, measured adolescents’ HPV vaccination rates along the series initiation to completion, and conducted path analyses to assess the associations among them. RESULTS Our survey results show that mothers’ engagement with anti-vaccine content is negatively associated with their children’s HPV vaccine vaccination rates via their increased overarching vaccine hesitancy. In contrast, maternal engagement with pro-vaccine SM content is not associated with either overarching vaccine hesitancy or HPV vaccine vaccination rates. These results remained significant after controlling for socioeconomic, demographic, and accessibility factors, suggesting that mothers’ engagement with anti-vaccine messages on SM explains above and beyond what other known factors explain. CONCLUSIONS Our results suggest that increasing overarching vaccine hesitancy, heightened by the infodemic, can substantially reduce HPV vaccination rates, even after accessibility factors are controlled. Our results imply that the negative impact of the COVID-19 pandemic can be extended for many years to come through depressed HPV vaccination rates. As a result, there is an urgent need to develop interventions to increase HPV vaccination rates and to address vaccine hesitancy among mothers who feel emotionally challenged during the pandemic. CLINICALTRIAL N/A


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Randi Dalene Bjerke ◽  
Ida Laake ◽  
Berit Feiring ◽  
Geir Aamodt ◽  
Lill Trogstad

Abstract Background Since the human papillomavirus (HPV) vaccine was introduced in Norway in 2009, the vaccine uptake has increased. Whether this increase is similar regardless of the girls’ country background is unknown. We examined changes in HPV vaccine uptake from 2009 to 2014 and studied the impact of parental education and income on HPV vaccine uptake according to country background. Methods Girls in the first six birth cohorts (1997–2002) eligible for HPV vaccination were identified through the National Registry. Information on HPV vaccination, country background and socioeconomic factors was extracted from the Norwegian Immunisation Registry and Statistics Norway. Risk differences (RDs) and confidence intervals (CIs) were estimated with linear binomial regression. A total of 177,387 girls were included in the study. Results The HPV vaccine uptake increased from 72.5% in 2009 to 87.3% in 2014. The uptake increased for girls in all country background categories. Highest vaccine uptake was observed in girls with East−/South-East Asian background, 88.9% versus 82.5% in the total population. Vaccine uptake decreased slightly with increasing parental education, RD = − 1.6% (95% CI: − 2.3% to − 0.8%) for highest compared with lowest education level. In contrast, the uptake increased with increasing household income, RD = 4.9% (95% CI, 4.3 to 5.5%) for highest compared with lowest quintile. Parental education had largest impact in girls with Asian background, RD = − 8.1% (95% CI − 10.5% to − 5.6%) for higher vs lower education. The largest impact of household income was observed in girls with background from Middle East/Africa, RD for a 200,000 NOK increase in income was 2.1% (95% CI 1.2 to 3.0%). Conclusions The HPV vaccine uptake differed with country background but increased over time in all country background categories. Moreover, the impact of education and income on vaccine uptake differed with country background.


2021 ◽  
Vol 9 ◽  
pp. 251513552199026
Author(s):  
Rony Abraham Jacob ◽  
Priya Srambical Abraham ◽  
Feba Rachel Thomas ◽  
Vytila Navya ◽  
Juny Sebastian ◽  
...  

Background: India has almost 225 million adolescent girls and they seem to be at a disadvantage, both economically and by their lack of knowledge on human papilloma virus (HPV) vaccine, when compared to adolescent girls of other Asian countries. Aim: To assess the prevalence of HPV vaccination and to identify the impact of education in improving the knowledge and perception about the HPV infection and vaccination among the parents of adolescent girls. Methodology: The prospective interventional study was conducted in four schools within a South Indian City, Mysuru. The informed consent form and the questionnaire were sent home with the identified adolescent girls during the pre-interventional phase. Educational sessions were conducted for the students in their school and an education leaflet was distributed to their parents. Three weeks later, questionnaires were re-administered to the parents via the enrolled girls and their responses were collected. Results: The prevalence of HPV vaccination in the study population was 4.4%. There was a statistically significant improvement in knowledge in the post-interventional phase of the study ( p = 0.001), but could not identify a significant change in their perception ( p = 0.479). Parents belonging to the socioeconomic class of upper middle and upper lower showed better improvement at the end of the study, with a percentage improvement of 58.93% and 48.44%, respectively. Conclusion: The study proved that the healt care professional can target school children to communicate effectively to their parents on the importance of HPV vaccine as the study clearly observed a positive behavioral change among the study population.


Author(s):  
Suchith Hoblidar ◽  
Suma S. Moni ◽  
Rathnamala M. Desai ◽  
Asha Neravi

Background: Cervical cancer is the second leading cause of death in india. it is also one of the few malignancies where an infectious etiological agent human papilloma virus (HPV) has been identified. With the advent of HPV vaccination, it is possible to reduce the morbidity and mortality associated with carcinoma cervix. But biggest hurdle to achieve this is the lack of awareness about the availability and use of HPV vaccine. This study was conducted to know knowledge and awareness of HPV infection and vaccination among medical and paramedical students. We also evaluated the acceptability and coverage of HPV vaccine among these students.Methods: This study was conducted among a total of 520 female students of the Sri Dharmasthala Manjunatheshwara University with the help of a questionnaire. The study group included 207 MBBS students, 167 BDS students, 89 nursing students and 57 physiotherapy students.Results: Most of the students were in 18-20 years’ age group. Nearly 40.57% of the students knew that HPV is sexually transmitted and 29.80% were aware that this infection can be prevented. Availability of HPV vaccine was known to 75% of the students and the main source of their information was through their college teachings. Nearly 43.75% of the students knew HPV vaccine protects against cervical cancer and 26.73% of the students were vaccinated. Overall knowledge and awareness were better among medical students.Conclusions: A lot of work needs to be done so as to make the target population accept HPV vaccine. There is a great difference between awareness of availability of the vaccine and its use. This emphasizes the need for health care professionals to take special interest in promoting this vaccine in the general population.


2016 ◽  
Vol 44 (3) ◽  
pp. 462-473 ◽  
Author(s):  
Allison M. Whelan

This article examines the rise of the anti-vaccination movement, the proliferation of laws allowing parental exemptions to mandatory school vaccines, and the impact of the movement on immunization rates for all vaccines. It uses the ongoing debate about the Human Papillomavirus (HPV) vaccine as an example to highlight the ripple effect and consequences of the anti-vaccine movement despite robust evidence of the vaccine's safety and efficacy. The article scrutinizes how state legislatures ironically promote vaccination while simultaneously deferring to the opposition by promulgating broad opt-outs from mandatory vaccine laws. This article concludes by offering an alternative legislative approach to specifically combat the anti-vaccine movement's impact on HPV vaccination rates. Lowering the age of consent has not been widely attempted or proposed and provides an alternative statutory mechanism to push back against vaccine resistance.


Vaccines ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1263
Author(s):  
Asami Yagi ◽  
Yutaka Ueda ◽  
Mamoru Kakuda ◽  
Satoshi Nakagawa ◽  
Kosuke Hiramatsu ◽  
...  

In Japan, government subsidies for human papillomavirus (HPV) vaccination of girls aged 13–16 commenced in 2010. By early 2013, vaccination had become a widely accepted national immunization program. However, in June of 2013, the Ministry of Health, Labor, and Welfare (MHLW), the government’s lead agency, suspended its recommendation for vaccination in response to reports of adverse vaccine events. The rate of HPV vaccination quickly dropped from 70% to almost zero, where it has lingered for eight years. In 2020, a new 9-valent HPV vaccine was licensed in Japan. The momentum seemed to be building for the resumption of HPV vaccinations, yet Japanese mothers remain widely hesitant about vaccinating their daughters, despite the well-proven safety and efficacy of the HPV vaccines. The Japanese government and our educational and medical institutions must work harder as a team to inform our parents and their children about the life-saving benefits of the HPV vaccine, and at the same time, we must respond to all their concerns and questions. The vaccine hesitancy of unvaccinated women born in 2000 and thereafter is a natural consequence of the suspension of the government‘s recommendation. We must also take every possible measure to reduce the significant risk for cervical cancer these women have.


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